Americans are not waiting until marriage to have sex:

More than nine out of 10 Americans, men and women alike, have had premarital sex, according to a new study. The high rates extend even to women born in the 1940s, challenging perceptions that people were more chaste in the past.

"This is reality-check research," said the study's author, Lawrence Finer. "Premarital sex is normal behavior for the vast majority of Americans, and has been for decades."

Finer is a research director at the Guttmacher Institute, a private New York-based think tank that studies sexual and reproductive issues and which disagrees with government-funded programs that rely primarily on abstinence-only teachings. The study, released Tuesday, appears in the new issue of Public Health Reports.

The study, examining how sexual behavior before marriage has changed over time, was based on interviews conducted with more than 38,000 people -- about 33,000 of them women -- in 1982, 1988, 1995 and 2002 for the federal National Survey of Family Growth. According to Finer's analysis, 99 percent of the respondents had had sex by age 44, and 95 percent had done so before marriage.

Even among a subgroup of those who abstained from sex until at least age 20, four-fifths had had premarital sex by age 44, the study found.

Finer said the likelihood of Americans having sex before marriage has remained stable since the 1950s, though people now wait longer to get married and thus are sexually active as singles for extensive periods.

The study found women virtually as likely as men to engage in premarital sex, even those born decades ago. Among women born between 1950 and 1978, at least 91 percent had had premarital sex by age 30, he said, while among those born in the 1940s, 88 percent had done so by age 44.

"The data clearly show that the majority of older teens and adults have already had sex before marriage, which calls into question the federal government's funding of abstinence-only-until-marriage programs for 12- to 29-year-olds," Finer said.

First comment: Hot. (I knew I liked Americans for one reason or another.)

Second comment: Hmmm, tell me again why we are giving huge quantities of money (hundreds of millions) to subsidize a policy that is a catastrophic failure?

I recognize a point of view that would argue that even if abstinence education fails utterly for most people, it works for some and we should aspire to perfection even if we are unlikely to achieve it. But I have a problem with that as well because abstinence equals perfection only for the minority. A minority of people are abstinent; a minority of people think that is a good idea. Fair enough, and far be it from me to tell them how to have sex lives. Why is their choice the majority's policy?

As physicians, we aren't in the business of judging people; we are in the business of saving lives and improving health. Thus, if you told me that boysenberry juice was the most effective way to prevent STIs, I would recommend it to my patients just the same. Abstinence education is not effective, so it is time to abandon it as a policy.